832 resultados para admission


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Partint de que els alumnes que arriben a l'EPS ja han assolit la decisió prèvia de seguir estudis tècnics, i després del primer semestre d'haver iniciat els seus estudis, els proposem una reflexió sobre els seus estudis i la possibilitat d'exposar les seves il·lusions i desencisaments respecte al que n'esperaven de la universitat. Aprofitem per a remarca-els-hi la disponibilitat dels processos que ha organitzat el Centre per a facilitar-els-hi la seva integració als estudis. Aquesta part del procés s'inicia amb l'oportunitat de respondre una enquesta preparada per a fer el seguiment de la seva inserció universitària amb preguntes de resposta oberta que al mateix temps d'ajudar a la verificació del funcionament de les diferents activitats de suport que els dóna l'escola, serveixen de invitació a la reflexió tant per als alumnes matriculats per primera vegada com per als professors i equip de direcció de l'Escola Politècnica Superior de la Universitat de Girona a qui es fan arribar els resultats de les valoracions de l'enquesta

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In this article we present a qualitative study conducted with six indigenous and six mestizos from Intercultural University of Chiapas. The aim of the study is to exemplify the mutual perception between different ethno-linguistic groups, as well as the possible change occurred after the admission to the University. That is, opinions about the other group after and before entering the University. We conclude that a higher education intercultural model can promote mutual understanding and relationship between indigenous and mestizos and thus combat prejudices and stereotypes

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El objetivo de la tesis doctoral es el análisis del recurso de apelación en el proceso civil desde su vertiente subjetiva. El estudio se centra en los sujetos que intervienen en el recurso de apelación, tanto en quienes han sido parte en primera instancia, com en los eventuales intervinientes o, incluso, terceros, es decir, aquellos sujetos que no han actuado en la primera instancia como partes originarias o intervinientes pero pretenden comparecer en apelación com intervinientes adhesivos. De otra parte, se ha analizado la bibliografía científica existente que trata sobre los diferentes aspectos de la teoría general de los recursos civiles, en especial sobre sus condiciones y presupuestos de adminsión. Si bien es cierto que no escasean valiosas obras relativas al objeto de la apelación, se echaban en falta, a mi juicio, estudios que abordasen específicamente y con la debida extebsión los aspectos subjetivos del recurso.

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O presente estudo que trata da formação e docência na educação infantil tem por objetivo realizar uma análise da percepção das docentes deste segmento acerca da infância, da educação infantil e do currículo para educação infantil, com vistas a observar as diferenças ocorridas em sua prática pedagógica após o ingresso no curso de licenciatura em pedagogia oferecido pelo PROGRAPE-UPE. Nele busca-se responder a seguinte questão norteadora: “Como se encontra a prática pedagógica e a percepção dos educadores para com a Educação Infantil e a importância do currículo para esse segmento educacional?”. Assim, direcionamos o aporte teórico desta pesquisa para questões como a história da educação infantil, em que buscamos traçar os primeiros passos desta no Brasil, em seguida traçar nossas considerações para concepção de criança ao longo dos tempos até chegar a percepção que se tem atualmente sobre a mesma, sobretudo como sujeito da relação de ensino-aprendizagem, onde buscamos a contribuição deixada por importantes teóricos como Piaget, Vygotsky e Wallon. Além disso, também direcionamos nosso olhar ao atual processo educacional da infância tendo em vista a função e reorganização curricular, em que delineamos algumas considerações sobre a história do currículo, e assim adentrarmos na abordagem do currículo para a educação infantil, tendo-se por base a importância da observação de seus três eixos junto a este segmento. E, por fim, tratamos da atuação docente e da importância da formação para aqueles que trabalham na educação de crianças entre 0 (zero) e 6 (seis) anos de idade. Neste percurso, a metodologia utilizada foi a pesquisa bibliográfica e documental, bem como, a pesquisa de caráter qualitativo, onde o instrumento de coleta de dados foi a entrevista, a qual foi realizada com uma amostra de 6 (seis) docentes da educação infantil, cuja avaliação foi feita com base na análise do discurso; de maneira que, ao seu final, pudemos perceber a importância do curso de formação tendo em vista um melhor entendimento por parte das docentes entrevistadas acerca da infância, da educação infantil e do currículo, bem como na melhoria de sua prática.

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Este estudo apresenta uma perspectiva da ‘janela’, como o dispositivo mais frequente de iluminação, na sua evolução e significado na arquitectura. A sua capacidade de caracterizar tendências e estilos arquitectónicos, permanece desde as primeiras referências históricas até aos elementos desenvolvidos e associados à iluminação natural dos dias de hoje. O interesse por este tema surgiu, principalmente, por ser o elemento arquitectónico que desde sempre permitiu a entrada de luz natural nas construções. Foi sempre um dos pontos de ligação e relação do interior com o exterior. Em determinadas situações tornou-se num elemento tão discreto, que nos passou despercebido, além de ter sido ocasionalmente desvalorizado. A janela ou dispositivo de iluminação natural, quando utilizado correctamente pode trazer muitos benefícios à arquitectura, assim como proporcionar conforto térmico sem necessidade de gastos energéticos excessivos.

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El Tratado de Adhesion firmado por Venezuela con MERCOSUR en 2006 adopta los principios de gradualismo, flexibilidad, equilibrio, reconocimiento de las asimetrías y trato diferencial. Las asimetrías pueden causar externalidades negativas, así como también pueden tener el potencial de promover el proceso de integración en una forma dialéctica. Esta es una de las premisas que guía este artículo. En este trabajo se analizarán las características de las asimetrías en MERCOSUR, cómo afecta la admisión de Venezuela a esta situación, el tratamiento dado a las asimetrías en MERCOSUR vis à vis la UE, y el tipo de instituciones que gestionan las asimetrías en MERCOSUR.

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Background: In a prospective observational study, we examined the temporal relationships between serum erythropoietin (EPO) levels, haemoglobin concentration and the inflammatory response in critically ill patients with and without acute renal failure (ARF). Patients and method Twenty-five critically ill patients, from general and cardiac intensive care units (ICUs) in a university hospital, were studied. Eight had ARF and 17 had normal or mildly impaired renal function. The comparator group included 82 nonhospitalized patients with normal renal function and varying haemoglobin concentrations. In the patients, levels of haemoglobin, serum EPO, C-reactive protein, IL-1β, IL-6, serum iron, ferritin, vitamin B12 and folate were measured, and Coombs test was performed from ICU admission until discharge or death. Concurrent EPO and haemoglobin levels were measured in the comparator group. Results: EPO levels were initially high in patients with ARF, falling to normal or low levels by day 3. Thereafter, almost all ICU patients demonstrated normal or low EPO levels despite progressive anaemia. IL-6 exhibited a similar initial pattern, but levels remained elevated during the chronic phase of critical illness. IL-1β was undetectable. Critically ill patients could not be distinguished from nonhospitalized anaemic patients on the basis of EPO levels. Conclusion: EPO levels are markedly elevated in the initial phase of critical illness with ARF. In the chronic phase of critical illness, EPO levels are the same for patients with and those without ARF, and cannot be distinguished from noncritically ill patients with varying haemoglobin concentrations. Exogenous EPO therapy is unlikely to be effective in the first few days of critical illness.

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Ordered graphite nanofibre formation has been observed at exceptionally low temperatures on admission of ethyne to zeolite Y, which had been exchanged with Ni(II). The samples have been characterised by TEM, carbon analysis, and electronic spectroscopy. Formation of the nanofibres requires no hydrogen, and was not observed when cation exchange was carried out at acidic pH. The observed fibres resemble herring-bone nanofibrils, growing from nickel particles, and ca. 90% have diameters in the range 35-40 nm. Similar fibres have also been grown using nickel-exchanged zeolite beta.

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This paper explores student and teacher perspectives of challenges relating to the levels of competence in English of Chinese students studying overseas from the perspective of critical pedagogy. It draws on two complementary studies undertaken by colleagues at the University of Reading. The first—a research seminar attended by representatives from a wide range of UK universities—presents the views of teachers and administrators; the second draws on four case studies of the language learning of Chinese postgraduate students during their first year of study in the UK, and offers the student voice. Interview and focus group data highlight the limitations of current tests of English used as part of the requirements for university admission. In particular, university teachers expressed uncertainty about whether the acceptance of levels of written English which fall far short of native-speaker competence is an ill-advised lowering of standards or a necessary and pragmatic response to the realities of an otherwise uneven playing field. In spite of this ambivalence, there is evidence of a growing willingness on the part of university teachers and support staff to find solutions to the language issues facing Chinese students, some of which require a more strategic institutional approach, while others rely on greater flexibility on the part of individuals. Although the studies reported in this paper were based on British universities, the findings will also be of interest to those involved in tertiary education in other English-speaking countries which are currently attracting large numbers of Chinese students.

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Background: Total enteral nutrition (TEN) within 48 h of admission has recently been shown to be safe and efficacious as part of the management of severe acute pancreatitis. Our aim was to ascertain the safety of immediate TEN in these patients and the effect of TEN on systemic inflammation, psychological state, oxidative stress, plasma glutamine levels and endotoxaemia. Methods: Patients admitted with predicted severe acute pancreatitis (APACHE II score 15) were randomised to total enteral (TEN; n = 8) or total parenteral nutrition (TPN; n = 9). Measurements of systemic inflammation (C-reactive protein), fatigue ( visual analogue scale), oxidative stress ( plasma thiobarbituric acid- reactive substances), plasma glutamine and anti-endotoxin IgG and IgM antibody concentrations were made on admission and repeated on days 3 and 7 thereafter. Clinical progress was monitored using APACHE II score. Organ failure and complications were recorded. Results: All patients tolerated the feeding regime well with few nutrition-related complications. Fatigue improved in both groups but more rapidly in the TEN group. Oxidative stress was high on admission and rose by similar amounts in both groups. Plasma glutamine concentrations did not change significantly in either group. In the TPN group, 3 patients developed respiratory failure and 3 developed non-respiratory single organ failure. There were no such complications in the TEN group. Hospital stay was shorter in the TEN group [ 7 (4-14) vs. 10 (7-26) days; p = 0.05] as was time to passing flatus and time to opening bowels [1 (0-2) vs. 2 (1-5) days; p = 0.01]. The cost of TEN was considerably less than of TPN. Conclusion: Immediate institution of nutritional support in the form of TEN is safe in predicted severe acute pancreatitis. It is as safe and as efficacious as TPN and may be beneficial in the clinical course of this disease. Copyright (C) 2003 S. Karger AG, Basel and IAP.

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Objective: To explore the causes of preventable drug-related admissions (PDRAs) to hospital. Design: Qualitative case studies using semi-structured interviews and medical record review; data analysed using a framework derived from Reason's model of organisational accidents and cascade analysis. Participants: 62 participants, including 18 patients, 8 informal carers, 17 general practitioners, 12 community pharmacists, 3 practice nurses and 4 other members of healthcare staff, involved in events leading up to the patients' hospital admissions. Setting: Nottingham, UK. Results: PDRAs are associated with problems at multiple stages in the medication use process, including prescribing, dispensing, administration, monitoring and help seeking. The main causes of these problems are communication failures ( between patients and healthcare professionals and different groups of healthcare professionals) and knowledge gaps ( about drugs and patients' medical and medication histories). The causes of PDRAs are similar irrespective of whether the hospital admission is associated with a prescribing, monitoring or patient adherence problem. Conclusions: The causes of PDRAs are multifaceted and complex. Technical solutions to PDRAs will need to take account of this complexity and are unlikely to be sufficient on their own. Interventions targeting the human causes of PDRAs are also necessary - for example, improving methods of communication.

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The aim of this study was to determine the cost effectiveness of influenza vaccination for healthy people aged 65-74 years living in the UK. People without risk factors for influenza (chronic heart, lung or renal disease, diabetic, immuno-suppressed or those living in an institution) were identified from 20 general practitioner (GP) practices in Liverpool in September 1999. 729/5875 (12.4%) eligible individuals were recruited and randomised to receive either influenza vaccine or placebo (ratio 3: 1)! with all participants receiving 23-valent-pneumococcal polysaccharide vaccine unless already administered. The primary analysis was the frequency of influenza as recorded by a GP diagnosis of pneumonia or influenza like illness. In 2000, the UK vaccination policy was changed with influenza vaccine becoming available. for all people aged 65 years and over irrespective of risk. As a consequence of this policy change. the study had to be fundamentally restructured and only results obtained over a one rather than the originally planned two-year randomised controlled trial framework were used. Results from 1999/2000 demonstrated no significant difference between groups for the primary outcome (relative risk 0.8, 95%, CI 0.16-4.1). In addition. there were no deaths or hospitalisations for influenza associated respiratory illness in either group. The subsequent analysis. using both national and local sources of evidence, estimated the following cost effectiveness indicators: (1) incremental NHS cost per GP consultation avoided = pound2000; (2) incremental NHS cost per hospital admission avoided = pound61,000: (3) incremental NHS cost per death avoided = pound1.900.000 and (4) incremental NHS cost per QALY gained = pound304,000. The analysis suggested that influenza vaccination in this Population would not be cost effective. (C) 2004 Elsevier Ltd. All rights reserved.

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The UK700 trial failed to demonstrate an overall benefit of intensive case management (ICM) in patients with severe psychotic illness. This does not discount a benefit for particular subgroups, and evidence of a benefit of ICM for patients of borderline intelligence has been presented. The aim of this study is to investigate whether this effect is part of a general benefit for patients with severe psychosis complicated by additional needs. In the UK700 trial patients with severe psychosis were randomly allocated to ICM or standard case management. For each patient group with complex needs the effect of ICM is compared with that in the rest of the study cohort. Outcome measures are days spent in psychiatric hospital and the admission and discharge rates. ICM may be of benefit to patients with severe psychosis complicated by borderline intelligence or depression, but may cause patients using illicit drugs to spend more time in hospital. There was no convincing evidence of an effect of ICM in a further seven patient groups. ICM is not of general benefit to patients with severe psychosis complicated by additional needs. The benefit of ICM for patients with borderline intelligence is an isolated effect which should be interpreted cautiously until further data are available.

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Movement disorders (MD) include a group of neurological disorders that involve neuromotor systems. MD can result in several abnormalities ranging from an inability to move, to severe constant and excessive movements. Strokes are a leading cause of disability affecting largely the older people worldwide. Traditional treatments rely on the use of physiotherapy that is partially based on theories and also heavily reliant on the therapists training and past experience. The lack of evidence to prove that one treatment is more effective than any other makes the rehabilitation of stroke patients a difficult task. UL motor re-learning and recovery levels tend to improve with intensive physiotherapy delivery. The need for conclusive evidence supporting one method over the other and the need to stimulate the stroke patient clearly suggest that traditional methods lack high motivational content, as well as objective standardised analytical methods for evaluating a patient's performance and assessment of therapy effectiveness. Despite all the advances in machine mediated therapies, there is still a need to improve therapy tools. This chapter describes a new approach to robot assisted neuro-rehabilitation for upper limb rehabilitation. Gentle/S introduces a new approach on the integration of appropriate haptic technologies to high quality virtual environments, so as to deliver challenging and meaningful therapies to people with upper limb impairment in consequence of a stroke. The described approach can enhance traditional therapy tools, provide therapy "on demand" and can present accurate objective measurements of a patient's progression. Our recent studies suggest the use of tele-presence and VR-based systems can potentially motivate patients to exercise for longer periods of time. Two identical prototypes have undergone extended clinical trials in the UK and Ireland with a cohort of 30 stroke subjects. From the lessons learnt with the Gentle/S approach, it is clear also that high quality therapy devices of this nature have a role in future delivery of stroke rehabilitation, and machine mediated therapies should be available to patient and his/her clinical team from initial hospital admission, through to long term placement in the patient's home following hospital discharge.

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Objectives To evaluate the effectiveness of integrated motivational interviewing and cognitive behaviour therapy in addition to standard care for patients with psychosis and a co-morbid substance use problem. Design Two-centre, open, rater-blind randomised controlled trial Setting UK Secondary Care Participants 327 patients with clinical diagnoses of schizophrenia, schizophreniform or schizoaffective disorder and DSM-IV diagnoses of drug and/or alcohol dependence or abuse Interventions Participants were randomly allocated to integrated motivational interviewing and cognitive behaviour therapy or standard care. Therapy has two phases. Phase one – “motivation building” – concerns engaging the patient, then exploring and resolving ambivalence for change in substance use. Phase two –“Action” – supports and facilitates change using cognitive behavioural approaches. Up to 26 therapy sessions were delivered over one year. Main outcomes The primary outcome was death from any cause or admission to hospital in the 12 months after therapy. Secondary outcomes were frequency and amount of substance use (Timeline Followback), readiness to change, perceived negative consequences of use, psychotic symptom ratings, number and duration of relapses, global assessment of functioning and deliberate self harm, at 12 and 24 months, with additional Timeline Followback assessments at 6 and 18 months. Analysis was by intention-to-treat with robust treatment effect estimates. Results 327 participants were randomised. 326 (99.7%) were assessed on the primary outcome, 246 (75.2%) on main secondary outcomes at 24 months. Regarding the primary outcome, there was no beneficial treatment effect on hospital admissions/ death during follow-up, with 20.2% (33/163) of controls and 23.3% (38/163) of the therapy group deceased or admitted (adjusted odds-ratio 1.16; P= 0.579; 95% confidence interval 0.68 to 1.99). For secondary outcomes there was no treatment effect on frequency of substance use or perceived negative consequences, but a statistically significant effect of therapy on amount used per substance-using day (adjusted odds-ratios: (a) for main substance 1.50; P=0.016; 1.08 to 2.09, (b) all substances 1.48; P=0.017; 1.07 to 2.05). There was a statistically significant treatment effect on readiness to change use at 12 months (adjusted odds-ratio 2.05; P=0.004; 1.26 to 3.31), not maintained at 24 months. There were no treatment effects on assessed clinical outcomes. Conclusions Integrated motivational interviewing and cognitive behaviour therapy for people with psychosis and substance misuse does not improve outcome in terms of hospitalisation, symptom outcomes or functioning. It does result in a reduction in amount of substance use which is maintained over the year’s follow up. Trial registration Current Controlled Trials: ISRCTN14404480